Downstate Medical Center with the support of the NIH sponsored Multipurpose Arthritis Center Grant has been studying various aspects of rheumatology education, research and community health care in Brooklyn. There are 3 components to our research, and they are listed below: 1. Research: we have been studying "Bronchoalveolar Lavage in Scleroderma" in the hope of shedding light on the inflammatory and immunological aspects of this disease. To date we have examined several such patients and controls. 2. Our education component is the largest of our center grant and involves the training of medical students, house staff, primary care physicians (in-patient and out-patient) and nurses in the hope of influencing the care of patients with arthritis related conditions; and in depth cost/benefit analysis is being undertaken to determine if such training is beneficial, cost effective and what modifications in our present system of educating these groups of health professionals needs to be done. In general, the level of care of the patients involved with these groups of health professionals will increase. 3. The last component is our community services: here we are attempting to determine the factors that influence a patient with an arthritis related condition to choose or not choose an entrance into the health care system; some choices are more beneficial than others, more expensive and more harmful than others; if the factors that determine the utilization of our health care system are determined, we can then modify them to deliver better, more cost effective health care. We have set up several "self-help" groups to study the nature of these groups in patients with rheumatologic disorders; are these groups similar to or distinctly different from other self help groups with chronic disorders? The last project involves a comparison of care by rheumatologists and primary physicians.